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Domperidone – Dopamine Receptor Antagonist

IntroductionDomperidone available under brand names Motilium, Pelton and others, is an antiemetic, stomach prokinetic drug, and galactagogue.
This drug helps the digestive system move more freely. It’s used to treat the signs and symptoms of gastric problems. It can also be used to prevent nausea and vomiting from drugs.
Class of MedicineDomperidone is a dopamine receptor antagonist that is used for dyspepsia, indigestion, epigastric pain, nausea, and vomiting as a peristaltic stimulant and anti-emetic.
Mode of ActionDomperidone is a peristaltic stimulant and a delayed gastric emptying adjuvant. Domperidone’s gastroprokinetic effects are linked to its peripheral dopamine receptor blocking abilities. By enhancing esophageal and gastric peristalsis and lowering esophageal sphincter pressure, domperidone speeds up gastric emptying and shortens small bowel transit time.Antiemetic: Domperidone’s antiemetic actions are linked to its ability to inhibit dopamine receptors at both the chemoreceptor trigger zone and the stomach level. It has great affinity for the D2 and D3 dopamine receptors, which are situated in the chemoreceptor trigger zone, which governs nausea and vomiting, among other things, just beyond the blood brain barrier.
Medical UsesDomperidone is a drug that helps people feel better while they’re sick. It aids in preventing you from feeling or being ill. It’s used to treat the signs and symptoms of gastric problems. It can also be used to prevent nausea and vomiting from drugs. If you’re receiving end-of-life care, it can also be used to alleviate stomach pain (palliative care).
Domperidone is occasionally used to boost milk production.
Avaiability & UsageDomperidone is available in tablet and syrup. It can be taken by mouth 30 minutes before meals and before bedtime as directed. Do not use this medication in higher doses or more frequently than recommended. Your condition will not improve any faster, but your chances of experiencing negative effects will increase.
Side EffectsAs your body adjusts to the medicine, you may experience

Headaches
Dizziness
Dry mouth
Nervousness
Flushing
Irritability for the first few days.

There have also been reports of difficulty sleeping, stomach cramps, heat flushes, and leg cramps. Inform your doctor if any of these side effects persist or become bothersome.
If you get chest pain, a slow/fast/irregular heartbeat, swelling of the feet or ankles, difficulty urinating, swelling of the breasts, or discharge from the nipple in men or women, call your doctor right once.

Important WarningDomperidone is contraindicated with powerful CYP3A4 inhibitors and other drugs that prolong the QTc interval due to its relation to QT interval prolongation. In older patients or those with a history of heart disease, dopamine should be administered with caution.
Available BrandsMotilium
Pelton

 

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Metronidazole – Nitroimidazole Antimicrobials – Antiprotozoal

Introduction

Metronidazole is an antibiotic and antiprotozoal medicine sold under the trade names Flagyl, Metrozine, Gramex and others. It’s used to treat pelvic inflammatory disease, endocarditis, and bacterial vaginosis, either alone or in combination with other antibiotics. Dracunculiasis, giardiasis, trichomoniasis, and amebiasis are also treated with it.
Metronidazole is a nitroimidazole that is also used to treat rosacea inflammatory lesions, bacterial infections, and surgical infections.

Class of Medicine
Metronidazole belongs to the nitroimidazole antimicrobials class of drugs. It works by preventing bacteria from growing.

Mode of Action
The nitroimidazole class includes metronidazole. It disrupts the DNA of microbial cells by inhibiting nucleic acid synthesis by producing nitroso radicals. This activity is only activated when metronidazole is partially reduced, and because this reduction occurs mostly in anaerobic bacteria and protozoans, it has only a minor impact on human cells and aerobic microorganisms.

How should this medicine be used?
After you’ve eaten some food, consume metronidazole tablets whole with a drink of water. It is not necessary to take metronidazole liquid after eating. To help you measure out the proper quantity, this medicine comes with a plastic syringe or spoon. If you don’t have one, you can get one from your pharmacist.

Common Side Effects

Dizziness

Headache

Stomach upset
Nausea
Vomiting
Loss of appetite
Diarrhea
Constipation

Important Warning

In persons with Cockayne syndrome, metronidazole can induce life-threatening liver issues.

Available Brands (list can be updated in future)
Flagyl
Metrozine
Gramex

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Flurbiprofen – NSAID – Pain Killer

Introduction

Flurbiprofen, also known as Froben, Inflamatix, Ansaid, Rasbid, and other brand names, is an NSAID that is used to treat the symptoms of osteoarthritis and rheumatoid arthritis.
Flurbiprofen is a non-steroidal anti-inflammatory medicine that has antibacterial efficacy against Trichophyton species, Microsporum species, and Epidermophyton species.

Class of Medicine
NSAIDs (nonsteroidal anti-inflammatory drugs) include flurbiprofen. It works by inhibiting the creation of a chemical that causes pain, heat, and inflammation in the body.

Mode of Action
Flurbiprofen’s anti-inflammatory activity is mediated through reversible inhibition of cyclooxygenase (COX), the enzyme that converts arachidonic acid to prostaglandin G2 (PGG2) and PGG2 to prostaglandin H2 (PGH2) in the prostaglandin production pathway, similar to other NSAIAs. This successfully lowers the levels of prostaglandins, which are responsible for inflammation, discomfort, swelling, and fever. Flurbiprofen is a non-selective COX inhibitor that suppresses both COX-1 and COX-2 activity. In terms of prostaglandin inhibitory activity, it is likewise one of the most powerful NSAIAs.

How should this medicine be used?
Flurbiprofen is available in tablet form, that must be swallowed. It’s commonly taken twice a day, up to four times a day. Flurbiprofen should be taken at the same time each day. Follow the directions on your prescription label carefully, and if there is anything you don’t understand, ask your doctor or pharmacist to explain it to you.

Common Side Effects

Upset stomach
Constipation
Diarrhea
Gas
Heartburn
Nausea
Vomiting
Dizziness
Drowsiness
Headache
If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Important Warning

This drug has the potential to produce a serious allergic reaction. Hives, rash, difficulty breathing, swelling of the neck or tongue, and chest pain are all possible symptoms. If you’ve had any of these symptoms or asthma after taking aspirin or other NSAIDs, don’t use flurbiprofen.

If you have a peptic ulcer or a bleeding issue, you should not use Flurbiprofen, unless a physician advises you otherwise.

Available Brands (list can be updated in future)
Froben
Inflamatix
Ansaid
Rasbid

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Methylcobalamin – Mecobalamin – Vitamin B12

Introduction

Methylcobalamin (mecobalamin, MeCbl, or MeB12) available in the brand names of Methycobal, Cobalmin, Mabil, Neuromet and others, is a kind of vitamin B12 known as cobalamin. Vitamin B12 insufficiency is treated with methylcobalamin. Vitamin B12 is required for the proper functioning of the brain and nerves, as well as the synthesis of red blood cells.
Methylcobalamin is also used to treat peripheral neuropathy, diabetic neuropathy, and amyotrophic lateral sclerosis as a preliminary treatment.
Pernicious anaemia, diabetes, and other diseases may necessitate the usage of methylcobalamin.

Class of Medicine
Mecobalamin and Methylcobalmin are two terms that are interchangeable and both belong to the vitamin B12 family (cyanocobalamin and analogues). Vitamin B12 insufficiency is treated with this supplement (Anemia). Vitamin B12 is required for the proper functioning of the brain and nerves, as well as the synthesis of red blood cells. In persons with pernicious anaemia, diabetes, and other diseases, methylcobalamin is sometimes used.

Mode of Action
Ingested methylcobalamin is first transformed to cob(II)alamin by MMACHC before being employed as a cofactor. Cob(II)alamin is then transformed into adenosylcobalamin and methylcobalamin, which are then used as cofactors. To put it another way, methylcobalamin is first dealkylated, then regenerated.

Treatment of vitamin B12 deficiency using hydroxocobalamin, cyanocobalamin, or a mix of adenosylcobalamin and methylcobalamin, rather than methylcobalamin alone, is critical.

How should this medicine be used?
Methycobalamin, often known as mecobalamin, is available in tablet, capsule, and injection form. Water-soluble vitamins are better absorbed when eaten on an empty stomach, which is the optimal way to eat. That means bringing them in for the first time in the morning, 30 minutes before eating, or two hours after eating. Water-soluble vitamins dissolve in water and are used by your body.
It could be injected every day or on alternate days when using injections.

Common Side Effects

Some of the common side effects of Methylcobalamin are:
Nausea
Vomiting
Diarrhea
Loss of appetite
Headache

Important Warning

Methylcobalamin can cause blood clots, diarrhoea, paresthesia, rhinitis, ataxia, pruritis, and allergic responses at high doses. Before starting this therapy, people with polycythemia should talk to their doctor [26-29]. This medication can be used as a topical paste on the skin without causing any side effects. This drug’s intravenous infusion can cause hypersensitivity reactions, which can lead to anaphylactic shock. While using methylcobalamin to treat megaloblastic anaemia, hypokalamia and thrombocytosis have occurred in certain patients.

Available Brands (list can be updated in future)
Methycobal
Cobalmin
Mabil
Neuromet

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Doxycycline – A Tetracycline Class – Antibiotic

Introduction

Doxycycline, available under brand names Vibramycin, Contimycin, Nordox and others. It is a broad-spectrum tetracycline-class antibiotic that is used to treat bacterial and parasitic diseases. Bacterial pneumonia, acne, chlamydia infections, Lyme disease, cholera, typhus, and syphilis are all treated with it. It’s also used in conjunction with quinine to prevent malaria.

Class of Medicine
Doxyycline belongs a a class of medicines called Tetracycline antibiotics,  It acts to cure infections by preventing germs from growing and spreading. It effectively treats acne by destroying bacteria that infect pores and reducing a natural greasy substance that causes acne. It combats rosacea by reducing the inflammation that causes the illness.

Mode of Action
In bacterial replication, a crucial contact for protein translation initiation occurs at the 3′ end of the 16S rRNA, which is present on the 30S subunit of the ribosome. The 30S subunit is the ribosome’s smallest subunit in prokaryotes, such as bacteria.
Tetracyclines, such as doxycycline, are hypothesised to prohibit tRNA from binding to the RNA-30S bacterial ribosomal subunit, which is required for the transport of amino acids for protein synthesis, by binding to the 16S rRNA part of the ribosome. The commencement of protein synthesis by polyribosome formation is prevented as a result of the preceding actions. Hence the replication of bacteria stops and produces a bacteriostatic effect

How should this medicine be used?
Doxycycline is available in the form of a capsule, a delayed-release capsule, a tablet, a delayed-release tablet, and a solution (liquid) for oral administration. Once or twice a day, doxycycline is commonly taken. With each pill, drink a full glass of water. If you have stomach problems while using doxycycline, take it with food or milk. If you take doxycycline with milk or food, the amount of medication absorbed from your stomach may be reduced.

Common Side Effects

Nausea
Vomiting
Diarrhea
Loss of appetite
Itching of the rectum or vagina
Sore or irritated throat
Swollen tongue
Dry mouth
Anxiety
Back pain
Changes in color of skin, scars, nails, eyes, or mouth

Important Warning

This medicine has the potential to induce significant skin responses. Stevens-Johnson syndrome, toxic epidermal necrolysis, and medication reactions with eosinophilia and systemic symptoms are among them (DRESS). Blisters, peeling skin, and a rash of small purple patches are some of the symptoms.

Available Brands (list can be updated in future)
Vibramycin
Contimycin
Nordox

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Loratadine – Anti Histamine – H1 Receptor

Introduction

Loratadine is an antiallergic drug, that is sold under the brand names Lorin NSA,  Xylor, Antial and others. Loratadine is an antihistamine that works by reducing the effects of the body’s natural chemical histamine. Sneezing, itching, watery eyes, and a runny nose are all symptoms of histamine. Sneezing, runny nose, watery eyes, hives, skin rash, itching, and other cold or allergy symptoms are treated with loratadine.

Class of Medicine
Loratadine belongs to the antihistamine class of drugs. Loratadine inhibits the activation of cells with H1 receptors by blocking one type of histamine receptor (the H1 receptor). It works by preventing histamine, a chemical in the body that produces allergy symptoms, from acting.

Mode of Action
In allergic rhinitis and urticaria, histamine release is a major mediator. As a result, loratadine works via binding to the H1 histamine receptors.

H1 histamine receptors can be found on the surface of epithelial cells, endothelial cells, eosinophils, neutrophils, airway cells, and vascular smooth muscle cells, among other things. H1 histamine receptors are part of the G-protein coupled receptor family, and they exist in a state of balance between active and inactive forms. Cross connecting between transmembrane domains III and V is facilitated by histamine binding to the H1-receptor, stabilising the active state of the receptor.

Antihistamines, on the other hand, bind to a different location on the H1 receptor, which favors the inactive form. As a result, loratadine is better characterised as a “inverse agonist” rather than a “histamine antagonist,” and it can help avoid or lessen the intensity of histamine-mediated symptoms.

How should this medicine be used?
Loratadine tablets should be swallowed with a glass of water, milk, or juice. If the pill has a score line, you can cut it in half if swallowing it whole is difficult. It is not to be chewed. Without the need for a drink, melt-in-the-mouth tablets dissolve instantaneously on your tongue.

Common Side Effects

Headache
Dry mouth
Nose-bleed
Sore throat
Mouth sores
Difficulty falling asleep or staying asleep
Nervousness
Weakness
sSomach pain
Diarrhea
Red or itchy eyes

Important Warning

If you are using loratadine for hives and experience any of the following symptoms, get immediate medical attention: Wheezing, drooling, dizziness, or loss of consciousness are all symptoms of difficulties swallowing, speaking, or breathing; swelling in and around the mouth or swelling of the tongue; wheezing; drooling; dizziness; or loss of consciousness.

Available Brands (list can be updated in future)
Lorin NSA
Xylor
Antial

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Cetirizine – H1 Receptor – An Anti-Histamine

Introduction

Cetirizine sold under the bran dames of Zyrtec, Rigix, Baydal, is a second-generation antihistamine that is used to treat allergic rhinitis (hay fever), dermatitis, and urticaria, among other things (hives). It is taken orally. The effects usually start within an hour and last approximately a day.

Class of Medicine
Cetirizine belongs to the antihistamine class of drugs. It works by preventing histamine, a chemical in the body that produces allergy symptoms, from acting.

Mode of Action
Cetirizine is an antihistamine medication that is a metabolite of hydroxyzine. Its major effects are obtained by inhibiting peripheral H1 receptors selectively. Cetirizine’s antihistamine activity has been demonstrated in a range of animal and human models. Anticholinergic and antiserotonergic effects were shown to be minimal in both in vivo and ex vivo animal models. However, dry mouth was found to be more common with cetirizine than with a placebo in clinical tests. Cetirizine has no measurable affinity for histamine receptors other than H1 receptors, according to in vitro receptor binding experiments.

How should this medicine be used?
Cetirizine tablets or capsules should always be taken with a glass of water, milk, or juice. Consume them in their whole. They should not be chewed. Cetirizine liquid, rather than pills or capsules, may be easier for youngsters to swallow.

Common Side Effects

Headaches
Dry mouth
Drowsiness
Fatigue
Feeling sick
Dizziness
Stomach pain
Diarrhoea
as well as more serious but uncommon adverse effects such as heart failure, tachycardia, and edoema.

Important Warning

In conclusion, cetirizine given daily for a long time (i.e. 3 years) may reduce the development of new sensitizations in monosensitized youngsters, indicating the possibility of tertiary allergy prevention.
When you stop taking cetirizine over a long period of time (usually more than six months), you may have generalized itching.


Available Brands (list can be updated in future)
Zyrtec
Rigix
Baydal

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Ebastine – Anti-Histamine – H1 Receptor

Introduction

Ebastine is a second-generation antihistamine, available in brand names Kestine, Ebaget, Atmos has been demonstrated to be helpful in the treatment of allergic rhinitis, both seasonal and perennial.
Ebastine is an H1 antihistamine with a modest drowsiness risk.
It does not permeate the blood–brain barrier very well, combining an effective inhibition of the H1 receptor in peripheral tissue with a low prevalence of central side effects, such as sedation and tiredness.

Class of Medicine
Ebastine is an H1 receptor antagonist of the second generation that is used to treat allergic rhinitis and chronic idiopathic urticaria. It comes in 10 and 20 mg tablets, as well as fast-dissolving tablets and paediatric syrup.

Mode of Action
Ebastine is a piperidine H1 antihistamine of the second generation. H1-antihistamines block histamine’s agonist effect at the H1 receptor and are used to reduce inflammation in allergic rhinitis, allergic conjunctivitis, and urticaria. Antigen presentation and the expression of pro-inflammatory cytokines, cell adhesion molecules, and chemotactic factors are all reduced when the activity of the NF-B immune response transcription factor is reduced via the phospholipase C and phosphatidylinositol (PIP2) signalling pathways. Furthermore, lowering the calcium ion concentration increases mast cell stability, which reduces the further release of histamine .

How should this medicine be used?
Ebastine can be taken with or without food once a day. Patients who are old or have mild–moderate hepatic impairment do not require dose adjustments. In patients with severe hepatic impairment, the maximum dose is 10 mg once day.

Common Side Effects

Nausea
Drowsiness
Dry mouth
Nose bleed
Weakness
Indigestion
Sleeplessness
Headache
Drowsiness
Abdominal pain
Pharyngitis
Dyspepsia
Asthenia
Sinusitis

Important Warning

Must talk to your doctor:
If the patient has the history of heart disease (e.g. long QT syndrome, hypokalaemia, treatment with agents known to increase QT interval). Use with CYP3A4 inhibitors at the same time.
Hepatic impairment is severe.
Children. Lactation and pregnancy.
If you are already taking certain antibiotics or drugs used to treat fungal infections

Available Brands (list can be updated in future)
Kestine
Ebaget
Atmos

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Atorvastatin – A Statin

Introduction

Atorvastatin, a genaric branded under the name of Lipitor, Lipiget, Lipirex is a statin drug used to treat abnormal cholesterol levels and prevent cardiovascular disease in people who are at high risk. Statins are a first-line medication for the prevention of cardiovascular disease. It is taken orally.

Class of Medicine
Atorvastatin is part of a class of drugs known as statins. If you’ve been diagnosed with high blood cholesterol, it’s used to lower it. It’s also used to prevent cardiovascular disease, such as heart attacks and strokes.

Mode of Action
The statin class of medications includes atorvastatin, which is a cholesterol-lowering treatment. Statins lower blood cholesterol levels by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, an enzyme required for the liver’s cholesterol production.

How should this medicine be used?
Because atorvastatin does not cause stomach distress, it can be taken with or without food. With a glass of water, swallow atorvastatin pills whole. Completely swallow the tablet with a glass of water. It should not be broken, crushed, or chewed. This drug can be taken with or without food. When taking atorvastatin, avoid drinking a lot of alcohol.

Common Side Effects

Headaches, nausea, diarrhoea, and cold-like symptoms are the most prevalent adverse effects.

Clinical research have found that 1–10% of patients using atorvastatin experience the following side effects:
Joint discomfort
Stools that are too loose
Indigestion
Muscle ache
Nausea
Hyperglycemia Atherosclerosis has also been linked to a worsening of blood sugar control when taken in high doses.

If you’re pregnant, trying to get pregnant, or breastfeeding, avoid taking atorvastatin. Even if you feel fine, keep taking atorvastatin since you will still reap the benefits.

Important Warning

While using atorvastatin, your risk of myopathy (muscle discomfort, soreness, or weakness) and rhabdomyolysis (muscle breakdown) increases. If you’re a senior, have thyroid issues, or have kidney disease, your risk is higher.

Available Brands (list can be updated in future)
Lipitor
Lipiget
Lipirex

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Eperisone – An Antispasmodic – Centrally Acting Muscle Relaxant

Introduction
Eperisone (eperisone hydrochloride salt) available under brand name Myonal, Karisona, is an antispasmodic medication. Eperisone works by relaxing both skeletal and vascular smooth muscles, and it has a wide range of effects, including decreased myotonia, improved circulation, and suppression of the pain reflex.

Class of Medicine
Eperisone (eperisone hydrochloride salt) is a centrally acting muscle relaxant an Antispasmodic class of medicine. Eperisone works by relaxing both skeletal and vascular smooth muscles, and it has a wide range of effects, including decreased myotonia, improved circulation, and suppression of the pain reflex.

Mode of Action
The centrally acting muscle relaxant eperisone hydrochloride has showed potential in the treatment of pain. It works by inhibiting the voltage-gated sodium channels (VGSC) in the brain stem, which inhibits neuronal activity and pain feeling.

How should this medicine be used?
Eperisone comes in tablet form and can be taken orally 50 mg twice a day. Dosage should be adjusted based on age and symptoms. It’s best if you take it with food.
The treatment will last 14 days in total. Patients will be screened for baseline parameters before being randomly assigned to one of two groups, according to a preset randomization schedule. For a period of 14 days, patients will be given either Eperisone-HCl (Myonal) or placebo.

Common Side Effects

Eperisone is not recommended for people who have a history of hypersensitivity to the medicine.
Common side effects includes:

  • Excessive relaxation
  • Stomachache
  • Nausea
  • Vertigo
  • Anorexia
  • Sleepiness
  • Skin rashes
  • Diarrhoea
  • Vomiting
  • Indigestion
  • GI troubles
  • Insomnia
  • Headache
  • Constipation
  • other side effects are “very infrequent.”

Important Warning

When Eperisone is taken with 1,2-Benzodiazepine, the risk of or severity of undesirable effects can rise.
When Eperisone is coupled with Abametapir, the serum levels of Eperisone can rise.
When Eperisone and Acarbose are combined, the risk or severity of hypoglycemia can be enhanced.
When Eperisone is taken in combination with Acemetacin, the risk of hyperkalemia is enhanced.
When Acetazolamide and Eperisone are combined, the risk of or severity of undesirable effects can be enhanced.
When Eperisone is coupled with Acetohexamide, the risk or severity of hypoglycemia may be enhanced.

Available Brands (list can be updated in future)
Myonal
Karisona